氯氮平齐拉西酮利培酮对精神分裂症患者脂代谢的影响

目的 探讨氯氮平、齐拉西酮、利培酮对精神分裂症患者脂代谢的影响,为临床安全用药提供依据.方法 将126例精神分裂症患者随机分为氯氮平组、齐拉西酮组和利培酮组,每组42例,分别口服氯氮平、齐拉西酮、利培酮治疗,观察8周.于治疗前及治疗8周末采用阳性与阴性症状量表评定临床疗效,同时检测血脂水平.结果 治疗8周末3组患者阳性与阴性症状量表总分及各因子分均较治疗前显著下降(P＜0.01),有效率差异无显著性(P＞0.05).治疗后3组血脂水平均有不同程度的增加,其中氯氮平组血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平均显著高于齐拉西酮组和利培酮组,齐拉西酮组血清总胆固醇、三酰甘油水平显著高于利培酮组(P＜0.05或0.01).结论 氯氮平、齐拉西酮和利培酮对精神分裂症患者血脂代谢均有不同程度的影响,但氯氮平对血脂影响最显著,齐拉西酮和利培酮影响较小,因此,对服用氯氮平治疗的患者应定期监测血脂水平.

Influences of clozapine, ziprasidone and risperidone on lipometabolism of schizophrenics

Objective To explore the influences of clozapine, ziprasidone and risperidone on lipome tabolism of schizophrenics in order to provide basis for clinical safe medication. Methods 126 schizophrenics were randomly assigned to three groups of 42 patients each, they took orally clozapine, ziprasidone or risperidone respectively for 8 weeks. Efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS） and blood fat levels detected before and after treatment. Results At the end of the 8^th week, the total and each factor score of three groups lowered more significantly compared with pretreatment （P〈0.01）, effective rates had no significant differences （P〈0.05）. After treatment, blood fat levels of 3 groups had various degrees of increase, serum total cholesterol, triacylglycerol and LDL- ch levels were all significantly higher in clozapine than in ziprasidone and risperidone group, so were serum total cholesterol and triacylglycerol in ziprasidone than in risperidone group （P〈0.05 or 0.01）. Conclusion Clozapine, ziprasidone and risperidone all have various degrees of influence on lipometabolism of schizophrenics, but clozapine＇s influence is the greatest, ziprasidone＇s and risperidone＇s less, so blood fat levels should be regularly detected for patients on elozapine.